Organization
PHOENIX ANESTHESIA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK TEETER M.D. (PRESIDENT)
(479) 785-2555
Entity
Organization
Contact information
Practice address
3601 WE KNIGHT DR, FORT SMITH, AR 72903-6249
(479) 709-6702
(479) 709-6730
Mailing address
PO BOX 11286, FORT SMITH, AR 72917-1286
(479) 785-2555
(479) 785-3555
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
07/22/2008
Last updated
05/20/2009
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